Active NPI
Tippecanoe Township
- Ambulance
- North Webster, IN
National Provider Identifier
1124151550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- License
- 0205
- Legal business name
- TIPPECANOE TOWNSHIP
- Practice address
- 202 N. Main St.
North Webster, IN 46555-9999 - Phone
- (574) 834-7676
- NPI assigned
- Mar 14, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeremy Likens
- Title
- Chief
- Phone
- (574) 457-5507
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 0205 | IN | Primary |
Addresses
Primary practice location
202 N. Main St.
North Webster, IN 46555-9999
Mailing address
PO Box 392907
Pittsburgh, PA 15251
Phone (800) 962-1484
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100281970A | Medicaid | IN | |
| 590009202 | Other | IN | MEDICARE ID |
Other names 1
- North Webster Tippecanoe Township EMS
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130312000484 | IN | Part B Supplier - Ambulance Service Supplier | 2365697604 | Practice locations: North Webster, IN |
National Provider Directory
National Provider Directory- Tax ID family
- No Webster Tippecanoe E
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ambulance
- North Webster, IN
- NPI 1497084552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1716163200000",
"number": "1124151550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 392907",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "15251",
"telephone_number": "800-962-1484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 N. MAIN ST.",
"city": "NORTH WEBSTER",
"state": "IN",
"postal_code": "465559999",
"telephone_number": "574-834-7676"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TIPPECANOE TOWNSHIP",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-14",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A",
"authorized_official_last_name": "LIKENS",
"authorized_official_first_name": "JEREMY",
"authorized_official_title_or_position": "CHIEF",
"authorized_official_telephone_number": "574-457-5507"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": "IN",
"license": "0205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100281970A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "590009202",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "North Webster Tippecanoe Township EMS",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "North Webster Tippecanoe Township EMS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in North Webster, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.